Which entity cannot bill for medically unnecessary services?

The entity that cannot bill for medically unnecessary services is patients. Patients, as consumers of healthcare, receive services and are the ones who are usually billed for those services after they are rendered. However, it is essential to clarify that they do not have the authority or ethical grounding to bill for services based on their own determination of necessity.

Billing for medically unnecessary services violates the standards of healthcare practice and regulatory requirements, which aim to ensure that medical billing is based on services that have a legitimate medical purpose. Healthcare providers, including hospitals, physicians, and ancillary providers, are responsible for assessing the necessity of services based on medical guidelines and standards of care before billing.

In contrast, patients typically rely on providers to determine the medical necessity of the services they receive. Thus, it is inappropriate for them to bill for any services, particularly those deemed medically unnecessary. This emphasis on the responsibility of providers in billing and the reliance of patients highlights why patients cannot bill for such services.